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定义儿科重症监护病房的“善终”。

Defining a "Good Death" in the Pediatric Intensive Care Unit.

机构信息

Elizabeth G. Broden is a doctoral student, University of Pennsylvania School of Nursing, and a registered nurse, Pediatric Intensive Care Unit, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Janet Deatrick is a professor emerita, Department of Family and Community Health, University of Pennsylvania School of Nursing.

出版信息

Am J Crit Care. 2020 Mar 1;29(2):111-121. doi: 10.4037/ajcc2020466.

Abstract

BACKGROUND

Societal attitudes about end-of-life events are at odds with how, where, and when children die. In addition, parents' ideas about what constitutes a "good death" in a pediatric intensive care unit vary widely.

OBJECTIVE

To synthesize parents' perspectives on end-of-life care in the pediatric intensive care unit in order to define the characteristics of a good death in this setting from the perspectives of parents.

METHODS

A concept analysis was conducted of parents' views of a good death in the pediatric intensive care unit. Empirical studies of parents who had experienced their child's death in the inpatient setting were identified through database searches.

RESULTS

The concept analysis allowed the definition of antecedents, attributes, and consequences of a good death. Empirical referents and exemplar cases of care of a dying child in the pediatric intensive care unit serve to further operationalize the concept.

CONCLUSIONS

Conceptual knowledge of what constitutes a good death from a parent's perspective may allow pediatric nurses to care for dying children in a way that promotes parents' coping with bereavement and continued bonds and memories of the deceased child. The proposed conceptual model synthesizes characteristics of a good death into actionable attributes to guide bedside nursing care of the dying child.

摘要

背景

社会对临终事件的态度与儿童死亡的方式、地点和时间不一致。此外,父母对儿科重症监护病房中“善终”的看法差异很大。

目的

综合父母对儿科重症监护病房临终关怀的观点,从父母的角度定义在这种环境下善终的特征。

方法

对父母在儿科重症监护病房善终的观点进行概念分析。通过数据库搜索,确定了在住院环境中经历过孩子死亡的父母的实证研究。

结果

概念分析允许定义善终的前因、属性和后果。儿科重症监护病房中垂死儿童护理的实证参考和范例案例进一步使该概念具体化。

结论

从父母的角度来看,对善终的概念性认识可以使儿科护士以促进父母应对丧亲之痛和继续保持与已故孩子的联系和记忆的方式照顾垂死的孩子。所提出的概念模型将善终的特征综合为可操作的属性,以指导临终儿童的床边护理。

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